Nor Najwatul Akmal Ab Rahman

Falls Risk Factors Among Hospitalized Older Adults

Hospitalized older adults have a higher risk of falls which will require longer hospitalization and increase in healthcare cost. The aim of our study was to determine falls risk factors among hospitalized older adults. Hospitalized older adults were recruited based on inclusion and exclusion criteria from January to March 2016. Participants’ demographic data was obtained and modified Baecke physical activity, general self-efficacy scale, and Lawton Instrumental Activities of Daily Living (IADL) questionnaires were administered. Participants performed Physiological Profile Approach (PPA) and Timed-Up and Go (TUG) tests. Ninety-six older adults admitted at medical wards (mean age of 70.15 ± 7.6 years) participated in this study. Approximately, 44% participants had experienced a fall. Results of PPA showed that approximately 90% of the participants have mild to high risk of falls. Hospitalized older adults aged 65 and above (OR = 3.12 95% CI 0.03-0.44, p < 0.05) and with four and higher number of medications (OR = 3.02 95% CI 0.04-0.76, p < 0.05) were identified to have a significant falls risk. Clinically, falls prevention care plan should be applied to all hospitalized older adults. However, hospitalized older adults aged 65 and above and taking four and more medications will require additional falls prevention care.

Community Service Learning among Health Sciences and Medical Undergraduates at a Malaysian setting: Providers’ and Recipients’ Portraits

Abstract Community Service learning (CSL) or Community engagement integrated teaching and learning (CEITL) offers reciprocal learning to both the providers and recipients. While it is important to consider the opinions of both parties for successful CSL, limited information exists in this topic area locally. The objective of this study was to explore undergraduates′ and communities′ perceptions regarding their experience and services provided during CSL. Recollections of 12 health sciences and medical undergraduates, and 18 members of the community whom participated in CSL programmes were sought using focus group discussions. This included their understanding of the programme, its benefits, challenges and their solutions and preferred activities. Undergraduates perceived CSL as an activity considered important to provide interactions between students and community. The perceived benefits of CSL were enhancement of interpersonal communication skills, negotiation of mutual understanding and experiencing real life situations. Undergraduates suggested that CSL should be well planned and scheduled. The CSL was seen by the communities as a platform for the recipients′ children to learn from the undergraduates as role models, future collaboration opportunities and health knowledge sharing. Weaknesses highlighted were; unstructured schedules, lack of variation in activities and CSL programme duration been too short to be effective. Suggestions provided for improved CSL were; extended time for health screening and better planned schedules. The findings suggest that undergraduates are aware of the significance of CSL in complementing their learning whereas the community have a positive outlook regarding CSL rendered by undergraduates. Further improvements are warranted in the implementation of more effective CSL programmes.

Correlation between thoracolumbar curvatures and respiratory function in older adults

Aging is associated with alterations in thoracolumbar curvatures and respiratory function. Research information regarding the correlation between thoracolumbar curvatures and a comprehensive examination of respiratory function parameters in older adults is limited. The aim of the present study was to examine the correlation between thoracolumbar curvatures and respiratory function in community-dwelling older adults. Thoracolumbar curvatures (thoracic and lumbar) were measured using a motion tracker. Respiratory function parameters such as lung function, respiratory rate, respiratory muscle strength and respiratory muscle thickness (diaphragm and intercostal) were measured using a spirometer, triaxial accelerometer, respiratory pressure meter and ultrasound imaging, respectively. Sixty-eight community-dwelling older males and females from Kuala Lumpur, Malaysia, with mean (standard deviation) age of 66.63 (5.16) years participated in this cross-sectional study. The results showed that mean (standard deviation) thoracic curvature angle and lumbar curvature angles were −46.30° (14.66°) and 14.10° (10.58°), respectively. There was a significant negative correlation between thoracic curvature angle and lung function (forced expiratory volume in 1 second: r=−0.23, P<0.05; forced vital capacity: r=−0.32, P<0.05), quiet expiration intercostal thickness (r=−0.22, P<0.05) and deep expiration diaphragm muscle thickness (r=−0.21, P<0.05). The lumbar curvature angle had a significant negative correlation with respiratory muscle strength (r=−0.29, P<0.05) and diaphragm muscle thickness at deep inspiration (r=−0.22, P<0.05). However, respiratory rate was correlated neither with thoracic nor with lumbar curvatures. The findings of this study suggest that increase in both thoracic and lumbar curvatures is correlated with decrease in respiratory muscle strength, respiratory muscle thickness and some parameters of lung function. Clinically, both thoracic and lumbar curvatures, respiratory muscles and lung function should be taken into consideration in the holistic management of respiratory function among older adults.